This proposal is a competing continuation request for T32-NR007104 originally funded in 1999 for the purpose of training nurse investigators in nursing outcomes research. It is a formal interdisciplinary program of pre-doctoral and post-doctoral study comprising the conceptual and empirical foundations and the methodologic approaches and statistical tools of advanced outcomes research. Research training in this program directly interfaces with related pre- and post-doctoral training programs across the University of Pennsylvania providing a network of educational opportunities for fellows that augment the rich experiences offered within the School of Nursing. The program is guided by the conceptual framework of the Quality Health Outcomes Model postulating that outcomes of nursing interventions are mediated by the organizational context in which care takes place and the characteristics of patients. Thus research fellows receive state of the science education in the measurement of the organizational context of care, patient risk adjustment methods, and nurse sensitive outcome measures. The program has as its goal the development of a cadre nurse researchers whose work will advance nursing science through rigorous testing and validation of this conceptual model for nursing outcomes research. The present grant funds 4 pre-doctoral and 4 post-doctoral fellows. We are requesting funding for the same number of positions. The program's first 9 years have been highly successful in terms of the recruitment of talented fellows including minorities, high visibility scientific publications by faculty and fellows, success of our fellows in competing for extramural grant funds, and the placement of those who have completed their fellowships in mainstream research positions where their research careers can continue to flourish. An External Review of the T32 program in nursing outcomes research is highly complimentary and supports program continuation. The program will continue its basic focus on identification of research questions of high relevance to clinical nursing practice, evidence-based management, and health policy, and the acquisition of knowledge of advanced quantitative methods to address important questions. New directions include 1) the integration of population health including the increased prevalence of chronic health conditions into research on the outcomes of nursing care, and 2) advances in translational research strategies and methods. RELEVANCE: This program produces nurse researchers who will create the knowledge base leading to patient-centered health care services that are safe and effective. They will discover through scientific research how to improve patient outcomes and attract and retain a qualified nurse workforce. Most will also educate the next generation of professional nurses.